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Drainage of an Abscess Near the Tonsil

Tennessee rates for HCPCS 42700

This procedure drains a pocket of infection that has formed in the tissue next to a tonsil, a condition that can cause severe throat pain, difficulty swallowing, and a muffled voice. The clinician makes a small opening to release the pus and relieve pressure in the area.

Rates data updated July 2026.

How much does Drainage of an Abscess Near the Tonsil cost?

$1,291

Typical total for the visit. In Tennessee, July 2026.

Insurers have agreed to pay about $1,291 for this procedure. That total is two separate charges: $195 to the doctor who performs it, and $1,096 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$195$148 to $251
Facility feeThe hospital or surgery center$1,096$355 to $2,291

How much rates vary

Facilitymedian $1,096 · 10th to 90th $178 to $3,090Professionalmedian $195 · 10th to 90th $132 to $398
$100$200$500$1K$2K$5K$10Kfacility $1,096professional $195

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$169.82
Median
$891.25
Typical High
$3,981.07
Aetna
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$194.98
Typical High
$380.19
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$204.17
Typical High
$354.81
BCBS
Setting
Facility
Modifier
Global
Typical Low
$616.60
Median
$1,445.44
Typical High
$2,041.74
BCBS
Setting
Professional
Modifier
Global
Typical Low
$151.36
Median
$239.88
Typical High
$398.11
Cigna
Setting
Facility
Modifier
Global
Typical Low
$154.88
Median
$281.84
Typical High
$467.74
Cigna
Setting
Professional
Modifier
Global
Typical Low
$134.90
Median
$204.17
Typical High
$346.74
Lucent Health
Setting
Facility
Modifier
Global
Typical Low
$1,995.26
Median
$2,238.72
Typical High
$19,498.45
Lucent Health
Setting
Professional
Modifier
Global
Typical Low
$1,380.38
Median
$1,621.81
Typical High
$1,621.81
United
Setting
Facility
Modifier
Global
Typical Low
$181.97
Median
$741.31
Typical High
$1,905.46
United
Setting
Professional
Modifier
Global
Typical Low
$125.89
Median
$190.55
Typical High
$331.13

Where Tennessee sits

The same service costs 15.2 times more in Delaware than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Tennessee· 22nd of 51

$1,291

$195 physician + $1,096 facility

DE $5,194MD $341

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.